Kidney Cancer Treatment Options
Radical Nephrectomy is the complete removal of the affected unit with the surrounding tissue. This includes the fat, adrenal gland, lymph nodes and Gerota’s fascia. This is currently the gold standard for removal of kidney tumors. This can be performed either robotically, laparoscopically or by an open procedure. The majority of renal tumors these days can be removed either robotically or laparoscopically, using small incisions and camera’s to visualize and remove the kidney intact. The same kidney specimen is removed as with the open procedure.
The long-term cancer control results are also no different between the open and laparoscopic or robotic procedures.
Benefits of Robotic-Assisted and Laparoscopic Nephrectomy vs. Open Radical:
- Smaller incisions (3-5 keyhole incisions)
- Less blood loss with no need for blood donation or transfusion
- Less pain
- Less narcotic usage
- Earlier discharge home (typical 24-72 hour stay for patient)
- Earlier ambulation
- Faster recovery
The use of robotics in kidney surgery is becoming increasingly prevalent. The daVinci surgical robot can be used to assist in laparoscopic kidney removal. The patient enjoys the benefits of laparoscopic surgery that are illustrated above, with the additional benefits of:
- Magnified three dimensional visualization
- Miniature wristed surgical instrumentation
- Intuitive motion with tremor filtration and motion scaling
Open Radical involves the removal of the kidney via a large flank or abdominal incision.
- Loin incision (12” or greater - Lower Side / Back)
- One of the most painful surgeries – Rib often has to be removed
- Prolonged Hospitalization 5-7 days
- Due to nerve/ muscle damage, many patients are left with an unsightly bulge
Partial nephrectomy is a nephron sparing procedure that removes the kidney tumor while leaving the non-cancerous part of the kidney intact. Long term studies have shown that in appropriately selected patients the results of partial and radical nephrectomy are similar in terms of long term survival. Partial nephrectomy is becoming the standard of care for many patients with kidney cancer. Partial nephrectomy can be performed both with open, robotic or laparoscopic surgery.
Robotically Assisted Laparoscopic Partial Nephrectomy the use of robotics in kidney surgery is becoming increasingly prevalent. This state of the art minimally invasive procedure removes the kidney cancer through small incisions while preserving the remaining normal kidney. The patient enjoyed the benefits of laparoscopic surgery that are illustrated above.
Open Partial Nephrectomy involves an open flank or abdominal incision to localize the kidney. The tumor is located and removed while the rest of the kidney is left intact. The long term results for cancer control have been favorable.
Laparoscopic Partial Nephrectomy involves the creation of small holes in the abdomen through which small camera’s are passed to visualize and remove the tumor while leaving the rest of the kidney intact.
Renal Ablation involves destruction of the tumor on the kidney using minimally invasive nephron sparing techniques. The tumor is localized and treated with energy that kills the tumor cells while leaving the surrounding tissue intact and functioning. This results in preservation of the rest of the kidney while the tumor is destroyed.The technology is relatively new and is currently only performed in select centers that have experience with ablative technologies. Short term results have been promising and have provided a new surgical treatment option to patients that desire not to have the whole kidney removed. Currently, there are two main types of renal ablation.
Radiofrequency Ablation: This involves laparoscopic and/or radiographic localization of the kidney tumor followed by delivery of heat via a small percutaneously placed needle. This allows heating of the tumor and ablation of the cancerous cells. The treatment is monitored in realtime via temperature probes, visually and with the use of ultrasound. Recent experience shows that the procedure is safe and effective for treatment of renal tumors. Further long term study is ongoing.
Cryoablation: This involves laparoscopic and/or radiographic localization of the kidney tumor followed by freezing the tumor with percutaneously placed needles. This allows cooling of the tumor and ablation of the cancerous cells. The treatment is monitored in realtime via temperature probes, visually and with the use of ultrasound. Recent experience shows that the procedure is safe and effective for treatment of renal tumors. Further long term study is ongoing.
For more kidney cancer treatment options or to learn about candidacy requirements for robotic kidney surgery, contact us today.